The use of a hollow polymethylmethacrylate cervical spacer with plating in the treatment of single level cervical disc disease.

Background: At present, the use of a cervical cage and plating has become an accepted and widely practiced surgical intervention for the treatment of cervical spondylosis and disc herniation. Polymethylmethacrylate (PMMA) bone cement has been used in cervical disc disease as a spacer, with good longterm outcomes, but the method does not result in solid bone fusion in all cases. Methods: A prospective study was performed with 92 consecutive patients who underwent single-level anterior cervical discectomy and fusion (ACDF) with a hollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization between January 2002 and December 2003. Patients were followed for a minimum of 2 years. Results: The surgical procedures used were technically successful for all patients, and there were no major complications related to anesthesia or the overall surgical procedure. The fusion rate was 89.8% at the 12-month follow-up, and 100% at the 24-month follow-up. The mean intervertebral disc height was 6.5 1.5 mm and regained height was 3.4 1.3 mm at the 24-month follow-up. The mean segmental lordotic angle was 3.7 2.0° with an increase of 6.1 2.3° at the 24-month follow-up. There was no hollow PMMA spacer dislodgment or failure. However, 5 (5.4%) patients had screw loosening and 3 (3.3%) patients underwent a secondary operation for removal of the plate and screws. Conclusions: The procedure for a single-level ACDF with a hollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization is safe and effective. There were no complications related to the hollow PMMA spacer. This procedure has a high fusion rate, and can restore disc height and maintain normal cervical lordosis. This method achieves results similar to those of other methods. (Chang Gung Med J 2009;32:447-54)